LA Marijuana Products:

Selecting Flower Products

Marijuana plant flowers and buds are now available for medicinal use. As the number of different marijuana strains continues to grow, it is becoming somewhat problematic when attempting to select the right strain for ones therapeutic goals.

To facilitate making the best choice, please read the following sections first:

Cannabis Clinical Application

Marijuana (Cannabis):

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On this page:

Links to other Pertinent Educational Pages:

Links to ALL Marijuana Educational Pages

 

The medical information on this site is provided as a resource for information only, and is not to be used or relied upon for any diagnostic or treatment purposes and is not intended to create any patient-physician relationship.  Readers are advised to seek professional medical guidance regarding the diagnosis and treatment of their medical concerns.

 

Key to Links:

  • Grey text – handout
  • Red text – another page on this website
  • Blue text – Journal publication

 

 

When inhaling, choosing natural flower products over other forms of cannabis

The choice of using natural marijuana flowers as the formulation for therapeutic use instead of vape cartridges, tinctures and edibles has advantages over these other formulations beyond simply being more affordable. Because the flowers have not been processed they contain all of the more than 100 pharmacologically active constituents typically associated with the particular strain of the flower.

It is often purported, and believed by many, that the ultimate therapeutic benefits related to marijuana are determined not solely by the summation of each singular constituents’ independent effects but instead they are also determined by the synergy of all, or at least of many, of the constituents acting together known as the “Entourage Effect.” It should be noted that while this is a commonly held belief with some supportive evidence in a limited number of settings, a lot of research has failed to identify clear evidence of significant entourage effects.

The distillates processed for use in tinctures or vaping cartridges are selectively limited, often with constituents added back in after distillation, and may not contain the optimal constituent profile associated with the identified strain to achieve the desired therapeutic benefits. Additionally, the carrier oils used to manufacture the vape cartridges are also being inhaled yet they offer no benefits of their own and may potentially contribute to detrimental side effects. Other vape products on the market for recreational purposes have been associated with safety concerns.

Finally, a reminder: vaping flower is preferred to smoking flower. It is healthier and is a more efficient means of extracting THC and terpenes from the flower, allowing for almost twice as much content per puff.

See: Smoking vs Vaping

Preface to Guiding the Selection of Cannabis Flowers

When it comes to selecting a cannabis flower for specific therapeutic benefits, it must be understood that at this time there exists no reliable means of doing so. The purpose of this section is to help the reader wade through this complex cannabis situation we all have to live with.

Although decades have passed since medical cannabis was legalized in California in 1996, no systematic approach exists for directing patients towards the cannabis products most likely to improve their symptoms. Nationwide, patients are directed towards products based on informal, scientifically arbitrary strain names essentially unrelated to any underlying plant characteristics. While Cannabis Sativa and Indica are the two primary marijuana species, many cannabis varieties share various traits of these two main cannabis species.

While early research identified some broad distinctions in the cannabinoid and terpene profiles that vary across C. sativa and C. indica (or hybrid) plant strains, these basic categories do not offer specific information on the unique characteristics of a product’s constituents.

Cannabis plant strain names, often the primary factor when purchasing a product, have very little scientific or practical relevance. It is reportedly not uncommon for producers and retailers to invent original strain names, use secondary sources (e.g., “Leafly”) to reference popular strain names, or even change the name of a strain if sales are not adequate.

Therefore, one cannot reliably know, based on current product descriptions, whether one strain of flower will have a similar effect to another or even whether products labeled as being the same strain will reliably generate the same effect.

Efforts to establish an indexing and categorization system for cannabis plants focus on separating cannabis plants into “chemovars,” distinguishing a plant’s chemical composition category based on its constituent profile. Early efforts focused only on the content of the two dominant cannabinoids found in cannabis, THC and CBD where three chemovar categories were identified:

  • Type I – THC-predominant
  • Type II – balance of THC and CBD
  • Type III – CBD-predominant

 

Before long, this over-simplification proved naïve as the chemical properties of a cannabis plant are dependent on a larger number of constituents, especially the estimated 200 terpenes found in cannabis. This has led to a continuously growing number of chemovars, now reported to include more than 700 unique chemovars. The chemovar system is the gold standard in cannabis classification.

Recent research is making some headway into categorizing chemovars based on their constituent content and, in turn, their reported therapeutic benefits. The benefits reported are currently based almost entirely on self-reporting surveys, especially a web-based app, “Releaf,” and surveys by their nature are not reliably accurate.

Decision Points

Since it is impossible at this time to provide completely accurate and reliable, specific identifications as to which flower is best for any specific therapeutic goal, one can make predictions of untried  products based on two methods only:

(1) Predictions based on which and how much of the constituents are present in the flower

(2) Predictions based on the experiences of others

 

(1) Predictions based on which and how much of the constituents are present in the flower

Unfortunately, even the product description provided by the grower, including their reported constituent analysis, is not reliable. The most reliable constituent analysis of any specific individual product will be the Certificate of Analysis (COA) produced by an independent lab that should be provided by the dispensary at time of sale and which should always be requested by the buyer. 

Regarding the cannabinoid and terpene profiles reported for the flowers, it should be noted that the relative content and percentages indicated will vary with growing conditions and from grower to grower as well as from crop to crop with the same grower. In the LA medical marijuana industry, however, the plants reportedly are cloned and grown in essentially the same conditions for every batch. According to the grower, there should be no greater than 15% variability from one batch to another. This constituent consistency is an important advantage over buying illicit-source marijuana products or even commercially available products in marijuana-legal states.

That being said, the process of analyzing constituent breakdowns is performed by independent testers, and their analysis can vary from batch to batch of the same flower based on transport and storage conditions which can alter the analysis making the entire process of identifying constituent profiles to have a built-in uncertainty.

The reported profiles here are provided to allow for ballpark predictions of constituent contents. Constituents with content of 0.05% or greater are purportedly considered to be potentially significant whereas connet >0.5% would be considered highly concentrated. The information available on this website for the terpenes remains limited at this time but more is added frequently, please check back. 

This page offers guidance based on what is known about the therapeutic benefits believed to be associated with specific constituents, with the caveat that our knowledge of the pharmacology of all known constituents remains in its infancy.

 

(2) Predictions based on the experiences of others

To begin with, the assumption that the flower strain being reviewed by another source, including its reported constituent analysis, will be the same as the flower strain of the same name available at the local dispensary is, unfortunately flawed and not at all reliable.

Setting the above aside for the moment, learning what other people say or believe about their experience with a particular flower strain is most reliable when there are large numbers of opinions tallied for review and when opinions are as unbiased as possible and not associated with someone attempting to sell the flower product.

Perhaps more importantly, for example in the case of reports of a pain benefit, the reviews will be most meaningful if the reviewers report the specific pain conditions for which they report pain relief since obviously there will he differences depending on the condition associated with the pain. Reviews provided by the websites below, for example, do not identify whether the reviewers suffer from chronic pain for example, or if they are simply recreational users with different goals for using the marijuana. Additionally, the reviews of the flowers do not specify if the flowers were smoked, vaped, or ingested, introducing yet another important variable of uncertainty.

Resources for product reviews potentially include informed pharmacists at designated marijuana dispensary pharmacies as well as popular websites such as www.Leafly.com and www.AllBud,com. When available, a summary of their reviews is included in the description of each flower strain summarized  here, in the section: LA Marijuana Products: Flower Products.

 

Ultimately, in the final analysis it often boils down to trial and error to gain experience with any particular strain to assess its benefits for any individual. While individuals may have their own unique response to a given strain, useful predictions based on cannabinoid and/or terpene profiles can used to provide suggestive guidance.

 

Selecting the Individual Flower Product for Personal Needs

Remember, the three components of marijuana that primarily determine its therapeutic benefit are THC, CBD and the terpenes. While other components found in cannabis likely do play a role in benefits, including CBG and other cannabinoids and flavonoids, they are not as likely to enter into the decision making of selecting a flower due to a lack of information regarding them.

Of these, CBD is usually not present to a significant degree in any of the flowers currently offered by LA cannabis dispensaries, so CBD content usually does not enter into the decision making.  THC is present in all of them, some more than others, so sometimes the amount of THC comes into play.  But largely it is the difference in terpene content that distinguishes one flower strain from another. Therefore it is important to evaluate the terpene profile present in a strain to predict the choice of flower strain most likely to meet personal needs. To learn which of each of these components offer benefits for pain, anxiety and sleep, please review Introductory Principles before proceeding.

 

Individual constituents and their contribution to therapeutic benefits

This section offers a brief summary of individual constituents and their contribution to therapeutic benefits. For more in-depth information on a constituent, click on its link.

Cannabinoids

THC

For more information on THC, click here

Although all strains have THC, some have more than others, so the strains with more THC may offer greater benefit, again depending also on their terpene content. Benefits generally ascribed to THC include pain relief, relaxation, sleep and anti-nausea. But the higher the THC content, also the more likely the strain will trigger anxiety and paranoia. It is therefore recommended that relatively inexperienced users start with lower THC dosing at less than 15- 20% THC content to avoid side effects and only experienced long-term marijuana users should turn to flowers with THC content >20%.

LA Flower strains with THC content of less than 20%:

    • Grease Monkey (THC 17-22%)
    • Lilac Diesel (THC 13.%)
    • Mandarin Zkittles (THC 11%) 
    • Lumpy Space Princess (THC 19%)

 

LA Flower strains with THC content of greater than or equal to 20%:

    • Grease Monkey (THC 17-22%)
    • Mandarin Cookies (THC 25%)
    • Pillow Factory (THC 21%)
    • Planet of the Grapes (THC 27%)

 

Supplementing flower with THC only

The use of supplemental THC-only tincture as break-through doses offers a longer duration dose of THC to improve pain, stress and relaxation, thus allowing less frequent need for smoking or vaping. Adding more isolated THC however may add more psychoactive side effects, including sedation,  anxiety or paranoia.

Another consideration is that the use of an oral tincture is not just longer-lasting but it involves the metabolism of THC to 11-hydroxy THC by the liver before entering the blood. The 11-hydroxy THC may provide enhanced analgesic or other therapeutic benefits compared to inhaled THC and/or less side effects. However, more THC may contribute to greater tolerance to the benefits of THC.

 

CBD

For more information on CBD, click here

CBD may offer a number of therapeutic benefits including management of pain, sleep and anxiety. It has also been proposed to facilitate the benefits of THC and suppress the side effects of THC. That being said, there is some evidence that CBD may actually interfere with the therapeutic benefits of THC and certain terpenes (see “Chemovars” below).

Since CBD is NOT PRESENT in significant amounts in any of the flowers currently offered. by the LA cannabis dispensaries, supplementing with a CBD product may offer greater therapeutic benefits for a particular flower strain based on one’s therapeutic goals. Several options are available for supplementing with CBD at least until a flower becomes available with more CBD, including a CBD isolate or a CBD product with an appropriate terpene profile as well.

 

Supplementing with CBD as hemp

Hemp flower is available at CBD stores in LA including strains that offer CBD levels up to 20% and more, levels that match the Δ-9 THC content of marijuana flowers. In addition, some strains also have CBG levels greater than 1% which is likely meaningful therapeutically. 

When one is vaping marijuana flower, a potentially preferred method to gain the most therapeutic benefit from the marijuana is to mix hemp flower with the marijuana flower to balance the THC with the CBD (and possibly CBG). Balancing THC and CBD content to appropriate levels and ratios may optimize the THC, providing the greatest therapeutic effects with less side effects. This method also provides the increased bioavailability advantages of inhalation over ingestion of the CBD.

 

Supplementing with formulations of CBD and terpenes

The use of supplemental CBD with terpenes may be less expensive than increasing a dose of a THC-based formulation and at the same time provide for more targeted therapeutic benefits. The additional CBD and terpenes will supplement the pain benefits of the THC and terpenes in the flower while also adding anxiety and sleep benefits. Additionally, the CBD may reduce any anxiety triggered by the flower’s THC.  Oral dosing of CBD for treating anxiety ranges from 10 mg to 200 mg and sometimes even up to 500 mg/day.

Selection of a CBD/terpene product can be challenging since identifying the terpenes and their amounts in a product is often difficult or impossible unless one can obtain a certificate of analysis of the product from the manufacturer. The best commercial products currently recommended that are highly concentrated with both CBD and a terpene profile that is excellent for pain, anxiety and sleep, are the CBD tinctures carried by CarolinaCannabinoids.US,

 

Supplementing with formulations of CBD, terpenes and THC

Included in the CarolinaCannabinoids line of products are those that provide broad spectrum formulations (with no THC) and 30 mg CBD/ml, with a full profile of terpenes high in BCP and beneficial for pain, anxiety and sleep.

 

Supplementing with formulations of full spectrum CBD (with <0.3% THC)

In addition, CarolinaCannabinoids offers full spectrum formulations (with <0.3% THC) that contain 100-200 mg CBD/ml. Importantly, these stronger formulations also utilize a Self Micro Emulsifying Delivery System (SMEDS) that enhances the bio-availability of all the included cannabinoids and terpenes, including CBDA and β-caryophyllene.

These water-soluble formulations contain 3000 mg or 6000 mg/CBD per 30 ml bottles. Although they are somewhat expensive with initial purchase, their high concentrations will likely allow for multiple months use from just one bottle. Also, because of their THC content they may trigger a positive drug screen for marijuana use.

 

 

Terpenes

For more information on terpenes, See: Terpenes, an Overview

Since none of the flower strains have CBD and all of the flower strains have THC, it is the terpene profile that likely provides the most therapeutic distinction from one strain to another. The terpene profile of a selected flower may not be optimal for one’s desired therapeutic goals. If one prefers greater therapeutic results than perceived with a particular strain, it is recommended to rotate to a different strain with a more beneficial therapeutic terpene profile rather than simply turning to a different strain with more THC.  Or, another alternative is to add additional terpenes.

Of over 200 identified terpenoids in cannabis, there seems to be consensus in the literature that between 17 to 19 are the most useful in defining a cannabis chemical profile, or chemotype.

 

Targeting Specific Terpenes

The following summary list represents the most common and the most relevant terpees. For more information, explore the link to each individual terpene listed below:

  1. Caryophyllene is a powerful anti-inflammatory and in especially effective against neuro-inflammation and neuropathic (nerve) pain.
  2. Humulene helps pain and is a strongly anti-inflammatory.
  3. Limonene reduces anxiety, is sedating and may be synergistic with CBD for these benefits. It is also an antioxidant and may help oxidative stress.
  4. Linalool is especially helpful for anxiety and insomnia. It has compelling evidence that it reduces pain with oral, topical and inhalation use.
  5. Myrcene at lower concentrations (<0.5%) it may help pain, reduce inflammation and act as a muscle relaxant but at higher concentrations (>0.5%) it aids insomnia and reduces anxiety but can be very sedating, contributing to the “couch-lock” experience.
  6. Pinene may have anti-inflammatory and analgesic benefits along with sedative, hypnotic and anxiolytic properties and may reduce the short-term memory impairment induced by THC.
  7. Terpinolene is purported to be sedating and calming.
  8. trans-Nerolidol  may have sedative properties and usefulness for insomnia. Nerolidol has weak pre-clinical animal studies suggesting it may be helpful in the treatment of neuropathic pain and inflammation but no human studies appear available to support targeting this terpene for use for pain

 

Treating conditions with specific terpenes

It can be quite helpful to select a particular cannabis flower when seeking a specific therapeutic benefit. One cna also consider supplementing the use of a flower with specific terpenes to target specific symptoms.

As more is learned regarding specific therapeutic benefits provided by individual or collective groupings of terpenes, more meaningful recommendations can be made. At this time however, specific recommendations for terpenes to target particular therapeutic benefits are somewhat limited.

Statistically, most people engaging the use of cannabis for medical purposes are doing so for the management of pain, sleep, anxiety and depression. This section attempts to provided meaningful recommendations for selecting specific terpenes for specific therapeutic benefits as a guide for selecting flowers based on their terpene profiles.

Note: for general purposes, “significant” content is defined as >0.05% while “high” content is defined as >0.5%

 

1. Pain

Remember, the most important constituent  in marijuana for managing pain is THC. But high doses of THC are not necessary for this benefit unless one has developed a high tolerance for THC based on long term, frequent use or high dosing. One can limit their use to flowers with lower concentrations (<15-20%) at least initially. Also, it is commonly reported that strains with roughly equal amounts of THC and CBD work best for pain. However, terpenes also play a significant role in managing pain with marijuana, most importantly β-caryophyllene.

The terpene β-caryophyllene has the strongest evidence for its benefit for pain and inflammation, including inhalation, ingestion and topical use. Topically-applied β-caryophyllene creams have been shown to be effective for pain, especially pain associated with peripheral neuropathies. Oral supplements of β-caryophyllene isolates are available and may be beneficial, but specific products or doses cannot be recommended at this time.

Flower strains with high content of β-caryophyllene based on Certificates of Analysis:

      • Black-Jack (THC (22.7%), β-Caryophyllene (0.206%), Terpinolene (0.163%), Humulene (0.88%),
      • Mandarin Cookies (THC (27.2%), β-Caryophyllene (0.42%), trans-Nerolidol (0.36%)
      • Chiesel (THC (27.3%), β-Caryophyllene (0.35%), trans-Nerolidol (0.26%), Limonene (0.21%),
      • Kool-Whip (THC (28.1%), Limonene (0.247%), trans-Nerolidol (0.168%), β-Caryophyllene (0.157%), Linalool (0.152%)
      • Peach Panther THC (26%), Myrcene 0.972%), β-Caryophyllene (0.526%), Limonene (0.470%), trans-Nerolidol (0.397%), Humulene (0.239%), β-Pinene (0.14%), Linalool (0.130%)
      • Slurty (THC (26.6%), β-Caryophyllene (1.1366%), Limonene (0.448%), Humulene (0.88%), Linalool (0.162%), Myrcene 0.116%), β-Pinene (0.115%), α-Pinene (0.105%)
      • Tire Fire (THC (29.7%), β-Caryophyllene (0.39%), trans-Nerolidol (0.344%), Limalool (0.333%), Limonene (0.307%), Humulene (0.145%), Myrcene 0.076%), β-Pinene (0.65%)

β-caryophyllene (BCP) supplementation: Commercial products of BCP are available for oral and topical use, see β-caryophyllene.

The terpene linalool also has strong evidence for its benefit for pain, including inhalation, ingestion and topical use. Of note, anxiety often accompanies and magnifies the pain experience so reducing anxiety can be synergistic with reducing pain and linalool has the strongest evidence as a terpene effective for anxiety.

The terpene humulene has limited evidence for pain relief and it is not recommended to target humulene for pain.

Flower strains with high content of β-caryophyllene and linalool: 

    • Berniehanna Butter (THC (22%), Linalool (0.817%), Limonene (0.671%), Myrcene (.537%), β-Caryophyllene (0.509%)

The terpene myrcene is often promoted has having benefit for pain, but in fact the evidence for this is weak and based mostly on animal studies and surveys that are not reliable.  It is not recommended here for myrcene to be targeted for pain benefits.

 

2. Anxiety

The terpene linalool has the strongest evidence for its benefit for anxiety, including inhalation, ingestion and topical use. Limonene also has evidence supporting its benefit for anxiety as does β-Caryophyllene and myrcene..

Flower strains with high content of linalool and/or limonene based on Certificates of Analysis:

    • Berniehanna Butter (THC (22%), Linalool (0.817%), Limonene (0.671%), Myrcene (0.537%), β-Caryophyllene (0.509%)
    • Cookies and Cream (THC (22%), trans-Nerolidol (0.381%), Limonene (0.349%), Caryophyllene Oxide (0.178%), Pinene (0.80%), Myrcene (0.062%), Linalool (0.062%), β-Ocimene (0.024%)
    • Kumquat (THC (27.5%), Ocimene (2.51%), trans-Nerolidol (0.963%), Limonene (0.481%), Terpinene (0.412%), Caryophyllene Oxide (0.361%), Linalool (0.335%), Pinene (0.115%),
    • Skunk Shocker (THC (23%), Caryophyllene Oxide (0.349%), trans-Nerolidol (0.205%), Linalool (0.133%), Myrcene (0.118%)

Linalool and limonene supplementation: For anxiety, one specific product of terpenes can be recommended for supplementation, CalmAid – an inexpensive OTC product for oral use containing the terpenes linalool and limonene derived from lavender oil which has good evidence for benefit for anxiety. It is commonly available at pharmacies and on the internet, costing $10-15 for a month supply. 

Additionally, the terpenes linalool and limonene can also be supplemented with the use of vaporizing essential oils rich in these terpenes, including lavender oil, bergamot oil and others.

 

 

3. Sedation and Sleep

Because THC can be sedating, all strains with THC potentially offer sedation as a dose-dependent benefit. However, at higher doses (>0.5%), the terpene myrcene appears to have the strongest evidence as a terpene for sedation and sleep. Myrcene is also known to be anxiolytic and since reducing anxiety can be synergistic with enhancing sedation and sleep, myrcene should be strongly considered when targeting a terpene for these benefits.

Strains that contain 0.5% or more of myrcene are usually described as indicas although in reality the “indica” distinction has little relevance currently. Myrcene is thought to be the component mostly responsible for “couch lock,” the term for heavy sedation associated with marijuana use.

Flower strains with high content of myrcene based on Certificates of Analysis:

    • Apex (THC (21%), Myrcene 0.314%)
    • Berniehanna Butter (THC (22%), Linalool (0.817%), Limonene (0.671%), Myrcene (0.537%), β-Caryophyllene (0.509%)
    • Petrol Pie (THC (21.9%), trans-Nerolidol (0.435%), Myrcene (0.300%), Caryophyllene Oxide (0.186%),   

 

 

What can be learned about constituent combinations from studies of chemovars

Based on the anecdotal information currently available, the following recommendations can be made for choosing which flower to try:

  • Grease Monkey if pain is your main concern
  • Mandarin Zkittles if sleep is a dominant concern
  • Mandarin Cookies if anxiety and/or depression are dominant concerns
  • Lilac Diesel may be best for feeling happy, relaxed and uplifting one’s mood while offering some pain benefit
  • Lumpy Space Princess appears to mostly offer an uplifting effect, with an energizing euphoria rather than relaxation, but it does not seem to stand out for pain benefit.
  • Planet of the Grapes should be avoided by the inexperienced or those sensitive to the side effects of THC

All strains above should provide relaxation, except Lumpy Space Princess which is more energizing, and all should provide some pain benefit.

 

Chemovar Studies

Preliminary research into predicting therapeutic benefits based on chemovars has provided some insights although reports are often inconsistent. A 2023 study was directed at indexing Cannabis flower strains based on the plant’s primary and secondary terpene concentrations and absolute THC and CBD potency levels in context of patient symptom relief for chronic pain, depression, and anxiety.

Of the five most frequent chemovars identified in the study, four of the five  chemovars containing myrcene as the primary or secondary terpene, all the chemovars had THC levels that ranged between 15 and 25%, and all but one had less than 1% CBD.

Total terpene contents in cannabis flowers generally range between 0.4% and 4%, while the monoterpenes and monoterpenoids  are the most abundant, forming together 46% to 83% of the total terpene composition and up to 10 mg or more per 100 mg cannabinoids. The most prevalent monoterpenes are myrcene, alpha pinene, beta pinene, and limonene.

Significant group differences in symptom relief were found across the chemovars as well as for patients treating only pain and for patients treating anxiety or depression. The chemovars with slightly higher-than-average levels (between 0.50 and 1.0%) of myrcene and terpinolene and no CBD appeared to be associated with reliably stronger therapeutic effects and the least likelihood of experiencing negative side effects.

Chemovars with the lowest terpene levels and any detectable amounts of CBD were associated with the least likelihood of experiencing positive benefits and the greatest likelihood of experiencing negative side effects. Additionally, chemovars with any identifiable amounts of CBD provided less symptom relief than those without CBD. This appears to contradict common reports of CBD providing synergistic benefits when accompanying THC both in enhanced benefits and reduced side effects such as anxiety.

Three monoterpenes, limonene, β-myrcene, and α-pinene, and two sesquiterpenes, β-caryophyllene and α-humulene, are abundant in the majority of chemovars. In North American chemovars, the following eight terpenes were predominant in 2015:

  1. β-myrcene
  2. terpinolene
  3. ocimene
  4. limonene
  5. α-pinene
  6. humulene
  7. linalool
  8. β-caryophyllene

However, a 2017 study evaluated a number of high THC cannabis strains or “chemovars,” based on their terpene content, describing 5 major group characteristics:

  1. Terpinolene dominant
  2. β-Caryophyllene dominant
  3. Limonene/myrcene dominant
  4. Limonene/myrcene/b-caryophyllene dominant,
  5. a-bisabolol/Myrcene dominant

By 2019, the quantity of the common top five terpenes included:

  1. β-myrcene
  2. a-pinene
  3. limonene
  4. β-caryophyllene
  5. terpinolene

However, the breakdown of these terpens varied substantially where they can be the single most abundant terpene in some chemovars or under the limit of detection in others.

 

Resources:

National Academy of Sciences

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

 

These lay-person websites appear to be good resources for exploring medical marijuana:

  1. www.GreenCamp.com
  2. www.Healer.com
  3. www.MedicalJane.com
  4. www.ProjectCBD.org
  5. analytical360.com
  6. www.leafly.com

 

 

Certificates of Ananlysis for Marijuana Products

Good Day Farms – Buds

  1. Apex (APEX) Buds – Good Day Farm – 44D-0965
  2. Banana Mac (BMAC) Buds- Good Day Farm – 44E-016134
  3. Berniehanna Butter (BRNB) Buds.- Good Day Farm – 44D-01428
  4. Black Jack (BJ) Pop- Good Day Farm – 44E-026069
  5. Black Jack (BJ) Pop[1] – Good Day Farm – 44E-026069
  6. Cookies (CO) Buds – Good Day Farm – 44D-1080
  7. Cookies (CO) Buds – Good Day Farm – 44E-017050
  8. Cookies & Cream (C&C) Buds- Good Day Farm – 44E-017054
  9. Cookies & Cream (C&C) Buds- Good Day Farm – 44E-017997
  10. Ghost OG (GOG) Buds – Good Day Farm – 44E-017045
  11. Kool Whip (KLWP) Buds – Good Day Farm – 44D-01449
  12. Kool Whip (KLWP) Buds
  13. Lumpy Space Princess (LSP) Buds.- Good Day Farm – 44E-017059
  14. Kumquat (KUMQ) Buds – Good Day Farm – 44D-01096
  15. Member OG (MOG) Buds – Good Day Farm – 44D-1082
  16. Peach Panther (PPR) Buds – Good Day Farm – 44D-01471
  17. Petrol Pie (PPIE) Buds – Good Day Farm – 44E-017047
  18. Skunk Shocker #15 (SS15) Buds – Good Day Farm – 44E-017042
  19. Slurty 3 (SLRT3) Buds – Good Day Farm – 44D-01470
  20. Tire Fire (TIFI) Buds – Good Day Farm – 44D-01478
  21. Titty Sprinkles (TS) Buds – Good Day Farm – 44E-017513

 

References:

Epidiolex (cannabidiol)

  1. FDA approves CBD drug – Epidiolex – The Washington Post

 

Marinol (dronabinol)

  1. Marinol – dronabinol

 

 Marijuana – Sativs vs Indica

  1. The Cannabinoid Content of Legal Cannabis in Washington State Varies Systematically Across Testing Facilities and Popular Consumer Products – 2018

 

Medical Marijuana – Chemovars

  1. Systematic combinations of major cannabinoid and terpene contents in Cannabis flower and patient outcomes – 2023

 

Medical Marijuana – Federal Law

  1. The legal status of cannabis (marijuana) and cannabidiol (CBD) under U.S. law – 2017

 

 

Medical Marijuana – Dosing

  1. Practical considerations in medical cannabis administration and dosing – 2018
  2. Measuring cannabis consumption – Psychometric properties of the Daily Sessions, Frequency, Age of Onset, and Quantity of Cannabis Use Inventory (DFAQ-CU) – 2017
  3. Quantifying Cannabis – A Field Study of Marijuana Quantity Estimation – 2018
  4. Bayesian inference for the distribution of grams of marijuana in a joint. – PubMed – NCBI – 2016
  5. Delphi Consensus – recommendations on dosing and administration of medical cannabis to treat chronic pain – results of a modified Delphi process – 2021
  6. Delphi Consensus – A cannabis oracle? Delphi method not a substitute for randomized controlled trials of cannabinoids as therapeutics – 2021
  7. Delphi Consensus – Clinical experience and COI disclosures
  8. Delphi Consensus – Dosing and Administration of Medical Cannabis- Physician Survey
  9. Delphi Consensus – Virtual Voting Round 2 Results Delphi Consensus – Voting Round 1 Results
  10. Consensus‐based recommendations for titrating cannabinoids and tapering opioids for chronic pain control – 2021

 

Medical Marijuana – Louisiana Law

  1. Louisiana-2016-SB180-Chaptered
  2. HOUSE BILL NO. 225 – 2017 Regular Session
  3. Louisiana medical marijuana expansion bill signed into law – May 20, 2016
  4. Now in Effect, Louisiana Medical Marijuana Law Shields Patients and Caregivers from Prosecution – Aug 5, 2016
  5. Louisiana-2016-SB180-Chaptered

 

Cannabidiol (CBD)- Overviews

  1. CANNABIDIOL (CBD) Pre-Review Report WHO 2017
  2. Cannabidiol – State of the art and new challenges for therapeutic applications. – 2017 PubMed – NCBI

 

CBD – Anxiety

  1. Overlapping Mechanisms of Stress-Induced Relapse to Opioid Use Disorder and Chronic Pain – Clinical Implications – 2016
  2. Cannabidiol Modulates Fear Memory Formation Through Interactions with Serotonergic Transmission in the Mesolimbic System – 2016
  3. Cannabidiol regulation of emotion and emotional memory processing: relevance for treating anxiety-related and substance abuse disorders. – PubMed – NCBI
  4. Review of the neurological benefits of phytocannabinoids – 2018
  5. Plastic and Neuroprotective Mechanisms Involved in the Therapeutic Effects of Cannabidiol in Psychiatric Disorders – 2017
  6. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. – PubMed – NCBI
  7. Evidences for the Anti-panic Actions of Cannabidiol – 2017
  8. Cannabidiol, a Cannabis sativa constituent, as an anxiolytic drug – 2012
  9. Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients – 2011

 

CBD – Interaction with THC

  1. Cannabidiol: a promising drug for neurodegenerative disorders? – PubMed – NCBI
  2. Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis – 2015
  3. Taming THC – potential cannabis synergy and phytocannabinoid-terpenoid entourage effects – 2011
  4. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. – PubMed – NCBI

 

 

CBD – Metabolites

  1. Human Metabolites of Cannabidiol – A Review on Their Formation, Biological Activity, and Relevance in Therapy – 2016

 

CBD – Drug-Metabolic Interactions

  1. Cannabidiol, a Major Phytocannabinoid, As a Potent Atypical Inhibitor for CYP2D6 – 2011
  2. The Effect of CYP2D6 Drug-Drug Interactions on Hydrocodone Effectiveness – 2014 
  3. Characterization of P-glycoprotein Inhibition by Major Cannabinoids from Marijuana – 2006

 

Medical Marijuana – Prescribing Guidelines

  1. Simplified guideline for prescribing medical cannabinoids in primary care – Canadian Family Physician – 2018
  2. Physician Recommendation of Medical Cannabis Guidelines Calif Medical Assoc – 2011
  3. Prescribing smoked cannabis for chronic noncancer pain. Preliminary recommendationsCanadian Family Physician – 2014

 

 

Medical Marijuana – Opioids

  1. Use-of-Prescription-Pain-Medications-Among-Medical-Cannabis-Patients
  2. It is premature to expand access to medicinal cannabis in hopes of solving the US opioid crisis – 2018
  3. Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort – 2018
  4. Patterns and correlates of medical cannabis use for pain among patients prescribed long-term opioid therapy. – PubMed – NCBI
  5. Associations between medical cannabis and prescription opioid use in chronic pain patients – A preliminary cohort study – 2017
  6. The prevalence and significance of cannabis use in patients prescribed chronic opioid therapy: a review of the extant literature. – PubMed – NCBI
  7. The use of cannabis in response to the opioid crisis: A review of the literature. – PubMed – NCBI
  8. Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010 – 2014
  9. Rationale for cannabis-based interventions in the opioid overdose crisis – 2017
  10. Cannabis and the Opioid Crisis – 2018
  11. Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability. – PubMed – NCBI
  12. Cannabinoid–Opioid Interaction in Chronic Pain
  13. Synergistic interactions between cannabinoid and opioid analgesics. – PubMed – NCBI
  14. FDA approves CBD drug – Epidiolex – The Washington Post

 

Medical Marijuana, Chronic Pain – Cannabinoids & Palmitoylethanolamide

  1. Therapeutic utility of palmitoylethanolamide in the treatment of neuropathic pain associated with various pathological conditions – a case series – 2012
  2. Palmitoylethanolamide, a naturally occurring lipid, is an orally effective intestinal anti-inflammatory agent – 2013
  3. Cannabinoid-based drugs targeting CB1 and TRPV1, the sympathetic nervous system, and arthritis – 2015
  4. Fatty acid amide hydrolase: biochemistry, pharmacology, and therapeutic possibilities for an enzyme hydrolyzing anandamide, 2-arachidonoylglycerol,… – PubMed – NCBI 2001
  5. Endocannabinoid-related compounds in gastrointestinal diseases – 2018
  6. ‘Entourage’ effects of N-palmitoylethanolamide and N-oleoylethanolamide on vasorelaxation to anandamide occur through TRPV1 receptors – 2008
  7. Medical Cannabis and Cannabinoids- An Option for the Treatment of Inflammatory Bowel Disease and Ca
    ncer of the Colon? – 2018
  8. Effects of homologues and analogues of palmitoylethanolamide upon the inactivation of the endocannabinoid anandamide – 2001
  9. Phytocannabinoids beyond the Cannabis plant – do they exist? – 2010
  10. Palmitoylethanolamide, endocannabinoids and related cannabimimetic compounds in protection against tissue inflammation and pain: potential use in c… – PubMed – NCBI
  11. Cannabinoids as pharmacotherapies for neuropathic pain – from the bench to the bedside. – 2009
  12. Correction – Effect of a new formulation of micronized and ultramicronized N-palmitoylethanolamine in a tibia fracture mouse model of complex regional pain syndrome – 2018
  13. Palmitoylethanolamide induces microglia changes associated with increased migration and phagocytic activity – involvement of the CB2 receptor – 2017
  14. Mast cells, glia and neuroinflammation – partners in crime? – 2013
  15. A Pharmacological Rationale to Reduce the Incidence of Opioid Induced Tolerance and Hyperalgesia – A Review – 2018

 

Medical Marijuana –Misc

  1. A tale of two cannabinoids: the therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. – PubMed – NCBI
  2. Cannabis and cannabis extracts – greater than the sum of their parts? – 2001
  3. Medical cannabis and mental health: A guided systematic review. 2016 – PubMed – NCBI
  4. Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly. – PubMed – NCBI
  5. Cannabis-conclusions – 2017 National Academy of Sciences
  6. Cannabis-chapter-highlights – 2017 National Academy of Sciences
  7. Cannabis-report-highlights – 2017 National Academy of Sciences
  8. Clinical Endocannabinoid Deficiency (CECD): Can this Concept Explain Therapeutic Bene ts of Cannabis in Migraine, Fibromyalgia, Irritable Bowel Syndrome and other Treatment-Resistant Conditions?-2004
  9. Marijuana use and the risk of lung and upper aerodigestive tract cancers: results of a population-based case-control study. – PubMed – NCBI
  10. Cannabis use and cognitive function: 8-year trajectory in a young adult cohort. – PubMed – NCBI
  11. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis. – PubMed – NCBI
  12. Cannabinoids and Cytochrome P450 Interactions. – PubMed – NCBI Pharmacogenetics of Cannabinoids – 2018
  13. Systematic review of systematic reviews for medical cannabinoids – 2018
  14. Adverse effects of medical cannabinoids – a systematic review – 2008
  15. Cannabimimetic effects modulated by cholinergic compounds. – PubMed – NCBI
  16. Antagonism of marihuana effects by indomethacin in humans. – PubMed – NCBI
  17. Pharmacokinetics and pharmacodynamics of cannabinoids. – PubMed – NCBI
  18. Clinical Pharmacodynamics of Cannabinoids – 2004
  19. Affinity and Efficacy Studies of Te
    trahydrocannabinolic Acid A at Cannabinoid Receptor Types One and Two. – 2017
  20. Quality Control of Traditional Cannabis Tinctures – Pattern, Markers, and Stability – 2016
  21. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: a systematic review. – PubMed – NCBI
  22. Pharmacology of Cannabinoids
  23. Current-status-and-future-of-cannabis-research-Clin-Researcher-2015
  24. Medical Marijuana for Treatment of Chronic Pain and Other Medical and Psychiatric Problems – A Clinical Review – 2015

 

Medical Marijuana – Products

Medical Marijuana – Product Evaluation

  1. The Cannabinoid Content of Legal Cannabis in Washington State Varies Systematically Across Testing Facilities and Popular Consumer Products – 2018
  2. Quality Control of Traditional Cannabis Tinctures – Pattern, Markers, and Stability – 2016

 

Medical Marijuana – Flower/Bud Products

Wellcana (Good Day Farm):

  1. Grease Monkey Flyer
  2. Lilac Diesel Flyer

 

Medical Marijuana – Topical Products

  1. Soothe Flyer
  2. Breathe Flyer

 

 

Emphasis on Education

 

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

 

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

 

Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

 

For more information, please contact Accurate Clinic.

 

Supplements recommended by Dr. Ehlenberger may be purchased commercially online or at Accurate Clinic.

Please read about our statement regarding the sale of products recommended by Dr. Ehlenberger.

Accurate Supplement Prices

 

 

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